CSF monoamine metabolite and beta endorphin levels in recently detoxified alcoholics and healthy controls: Prediction of alcohol cue-induced craving?

Background: Abnormalities in central neurotransmitter systems have been des cribed in alcohol-dependent individuals and may contribute to alcohol cravi ng. This study compared cerebrospinal fluid (CSF) levels of monoamine metab olites and beta endorphin levels in samples from early-onset alcohol-depend ent patients (n = 20), late-onset alcohol-dependent patients (n = 14), and healthy controls (n = 23); It also evaluated whether these CSF measures lev els predicted the degree of craving experienced in response to an alcohol c ue. Methods: Individuals meeting DSM-III and -IV R-criteria for alcohol depende nce, 1 to 3 months postdetoxification, and healthy controls underwent a lum bar puncture. Patients also completed a cue exposure test day between 3 and 15 days later. Results: Alcohol-dependent patients had lower CSF levels of the norepinephr ine metabolite MHPG compared with the healthy subjects, but this difference disappeared when differences in age between the groups were accounted for. No other group comparisons between patients and healthy subjects reached s ignificance. CSF levels of the dopamine metabolite HVA were significantly h igher in the early-onset patients compared with the late-onset patients and controls. The CSF measures did not predict the precue levels of craving, o r the increase in craving after alcohol cue exposure. Conclusions: These results are inconclusive about the role of monoaminergic dysregulation in recovering alcoholics. They also question the utility of these CSF measures to predict alcohol cue reactivity in patients who have b een sober at least 1 month.